Outcomes of a new tobacco treatment protocol at UWMC hospital

Bylund, Kristen

Wednesday, August 15, 2012

Exhibit Hall (Kansas City Convention Center)

Ms. Kristen Bylund, RN, MPHc , Health Services , University of Washington, School of Public Health , Seattle, WA

Dr. Abigail Halperin, MD, MPH , Family Medicine and Health Services, University of Washington, School of Medicine and Public Health , Seattle, WA

Beatriz Carlini, PhD, MPH , Alcohol and Drug Abuse Institute, University of Washington, Seattle, WA

Learning Objectives

At the conclusion of this presentation attendees will be able to:

Describe the treatment protocol for current smokers admitted to University of Washington Medical Center and Harborview Medical Center. Compare the tobacco screening rate before and after policy implementation. Identify the percent of patients who are current smokers and were offered, accepted and received nicotine replacement therapy and/or cessation counseling. Describe the relationship between screening and patient demographics such admission diagnosis, type of insurance and length of stay. Describe the relationship between delivery of tobacco cessation interventions and patient demographics.

Cross Cutting Program Area(s): Tobacco Control Policies and Evaluation and Surveillance

Audience: Those who are involved in the development, implementation and evaluation of treatment of tobacco use among hospitalized patients.

Key Points:

Two large hospitals affiliated with an academic medical center initiated systematic treatment of hospitalized patients who are tobacco users in conjunction with a new tobacco-free hospital campus policy.
This was accomplished through electronic medical record-based systems, including intake screening, physician orders, nursing protocol, and pharmacist delivered brief intervention.
Rates of screening for tobacco use, referral for treatment, uptake and receipt of NRT and counseling will be presented, along with predictors of screening and treatment, including demographics, admission diagnosis, hospital unit, length of stay and insurance coverage.
Challenges of program implementation and strategies for increasing uptake of tobacco treatment services by patients will be explored.

Educational Experience: The audience will learn about the background, processes, and challenges of a CPPW project systematizing tobacco screening and treatment at two large hospitals affiliated with an academic medical center. The presentation will include graphs comparing rate of screening, overall and by hospital unit, before and after the program was implemented. Further results regarding staff compliance with the new screening process, uptake of treatment by patients, and predictors of tobacco use screening and treatment, will be discussed with the presenter.

Benefits: In-hospital treatment of tobacco use and dependence is associated with improved long-term cessation rates and the Joint Commission has developed a new set of core measures for the screening and treatment of tobacco use among all hospital inpatients. This presentation will be helpful for others seeking to implement similar programs.

13 Outcomes of a new tobacco treatment protocol at UWMC hospital